Introduction

Aspergillosis is the name of a group of fungal conditions caused by a mould called aspergillus.

It usually affects the respiratory system (windpipe, sinuses and lungs) and causes wheezing and coughing, but it can spread to anywhere in the body.

Aspergillosis can usually be treated with medication, but in a few cases it's very serious and potentially life-threatening.

How do you get aspergillosis?

You can get aspergillosis if you inhale tiny particles of the aspergillus mould that hang in the air.

The mould is found in many different places, but it's particularly common in:

rotting leaves and compost

plants, trees and crops

air conditioning and heating systems

insulation material

dust

In most people, inhaling aspergillus particles isn't a problem, because your immune system quickly destroys them. However, aspergillosis can develop if you have a pre-existing lung condition, such as asthma or cystic fibrosis, or if you have a weakened immune system.

Aspergillosis isn't contagious, so it can't be passed from person to person.

Types of aspergillosis

Aspergillus mould can also sometimes infect other parts of the body, including the skin, eyes, sinuses and other internal organs, mainly in people with a weak immune system.

Allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis (ABPA) is caused by an allergy to inhaled aspergillus particles and typically causes wheezing, shortness of breath, a cough with mucus and sometimes blood. It's caused by the immune system reacting to the aspergillus mould.

ABPA usually affects people with asthma or cystic fibrosis. It's estimated that around 1 in every 40 people with asthma may be affected by ABPA.

There's also a very similar condition called severe asthma with fungal sensitisation (SAFS).

CPA can sometimes cause an aspergilloma (a fungal ball) to grow in the lungs. It can also result in the lungs becoming permanently scarred if it isn't treated.

It's estimated that around 400-750 people in England have CPA.

CPA requires specialist follow up treatment with antifungal medications and is usually long-term. The National Aspergillosis Centre offers specialist follow up of patients with CPA.

Invasive pulmonary aspergillosis

Invasive pulmonary aspergillosis (IPA) usually only affects people with a weak immune system, such as people who have received a bone marrow transplant or cancer treatment, or those with HIV or AIDS. It's the most serious type of aspergillosis.

If you have IPA, it's likely you'll have a raised temperature as well as lung symptoms, such as a cough, chest pain or breathlessness.

In IPA, the aspergillus mould can spread through the bloodstream from the lungs to the brain, eyes, heart or kidneys. This is very serious and can be life-threatening if it's not treated quickly.

IPA is estimated to affect up to one in every four people who've had a bone marrow transplant, a heart or lung transplant, or high-dose chemotherapy for leukaemia (cancer of the blood cells).

CPA and aspergilloma can be treated with long-term antifungal medication. In some cases, surgery may be needed to remove an aspergilloma from the lungs, prevent bleeding in the lungs, or remove infected tissue.

IPA is treated in hospital with powerful antifungal medications given by a drip into a vein. The infection can spread very quickly, and people who develop IPA are usually already very ill. This means that, unfortunately, around half of those with the condition die from it.